by Max Brantley
The legislative council's joint rules committee will convene tomorrow at 8:30 a.m. to review new state rules governing reimbursement procedures for organizations that provide residential care for the mentally ill. You may recall in years past that we learned Arkansas spent an extraordinarily disproportionate amount, around $250 million a year on residential treatment, in part because of the lobbying influence of the industry.
This is where Ted Suhl of the Lord's Ranch (now Trinity Behavioral Healthcare System) came in. One year, he spread $100,000 around legislative races to beat back reform and he was immensely influential during the Huckabee era. Background. And more background.
The industry and DHS has been working for two years on some changes to assure quality treatment, but also to control costs. That latter part is not popular with some operators.
Now, I'm told, Suhl's forces are circling like hungry vultures. Lobbyist Ted Mullenix is working in his service, for example, and undoubtedly others. This process had been non-controversial until recently. Now, suddenly, some legislators who previously talked loudly of tight-fisted, ethical governance are raising questions. Will they be entertained so long tonight that they can't make an 8:30 a.m. call to muster a quorum to pass this? We'll see.
Do you know where your legislator is tonight? Or whose pocket he's in tomorrow?
Some pluses of the rules under discussion:
* Proof that unlicensed workers are supervised by licensed health professionals
* A ratio of no worse than 10 unlicensed workers to every licensed worker.
* Psychiatrists must be consulted on use of certain types of medication, such as antipsychotics or stimulants.
* Facilities serving children under 21 must have access to a certified child psychiatrist, though that person need not be on premises or even in Arkansas.
* Consulting psychiatrists must participate in quarterly meetings on quality of care.
* Documentation of care and services must be accurate and compiled contemporaneously and must demonstrate compliance. This should end a practice of using one care plan and standard patient progress notes photocopied from one patient to the next.